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A claims adjuster is a representative of the insurance company. After a policyholder submits a claim, the adjuster comes in to investigate the loss. The loss can be anything from a major home flood or fire to a small window break or fender bender. They inspect homes, conduct interviews, consult records, or perform any number of duties to gather the details surrounding the reported event. The adjuster then interprets the customer’s insurance policy and determines what is covered. In many cases, adjusters negotiate the settlement on behalf of the insurance carrier and may authorize payments to the policyholder.

There are two basic employment options for adjusters: staff adjuster or independent adjuster. Staff adjusters work directly for the insurance carrier and independent adjusters work for Independent Adjusting Firms. IA Firms are relatively new in the insurance industry but now play a vital role in claims. Insurance companies know that there will be spikes and dips in claim volume from year to year, and they set policy premiums accordingly. For example, a large insurance company might expect 30,000 claims to be filed in Galveston, Texas during a normal year, but they realize that number could spike to 130,000 if a hurricane hits.

Claims fluctuate throughout a normal year too and these fluctuations present a staffing challenge for insurers. If they keep enough adjusters on the payroll to handle any contingency, they’d be overstaffed 90% of the time, decreasing their profitability. On the other hand, if they keep only a skeleton crew, the delay caused by trying to staff after a large spike would be disastrous for insurance companies. There are strict laws, steep fines, and public relations problems if claims are not handled on time, and it is difficult to hire qualified adjusters on short notice. Enter the Independent Adjusting Firm. Carriers now outsource claims to these firms and in turn, the firms can keep many more adjusters employed regularly.

In most states, you need to be licensed to adjust claims. The process, steps, and fees vary a bit by state but generally follow the same pattern. Get your home state, or Designated Home State (DHS) license if you live in a nonlicensing state. You need to take and pass your state adjuster exam, and submit a license application.

To see detailed instructions for your specific state, visit Adjuster Licensing. 

Yes! While there are 16 states that still do not license claims adjusters, the majority of states do. Employers, either insurance carriers or Independent Adjusting Firms, need adjusters who can work a multitude of claims in a variety of areas. You will give yourself the best chance for employment by obtaining your home state, or ‘designated home state’ license, and then getting reciprocal licenses so you can work in other states as well.

We recommend all new adjusters take our Xactimate live webinar. Being proficient in Xactimate’s estimating software is a vital skill for those just entering the industry. Once you obtain your license, it is also important to get specific carrier certifications like State Farm and Allstate. You won’t be able to work claims for those carriers unless you have their certifications. Most IA Firms offer free classes throughout the year to adjusters on their rosters. Rope access training is important for adjusters wanting to work steep, high, or complex height-related claims. FEMA offers courses for adjusters wanting to become NFIP certified. Ultimately, any additional certification you can obtain regarding fire and flood or water damage will serve you well.